File:The breast- its anomalies, its diseases, and their treatment (1917) (14570510917).jpg

Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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muscle; the pectoralisminor muscle is shown intact. The course of the mammary lymphatic vessels passing to these several groupsofnodes is a much disputed question. The anterior parietal lymphatic vessels of the thoraxcomprise the following: Cutaneous lymphatics.Lymphatics of the breast.Lymphatics of the peri-thoracic muscles.Lymphatics of the intercostal muscles.Lymphatics of the diaphragm. Of these the cutaneous lymphatic plexus is held to be of chief importance and to itthe mammary gland lymphatics are looked upon as tributary. The drainage of the 38 THE BREAST deeper portions of the breast into the lymph channels of the peri-thoracic muscles andtheir fascial coverings is held by Gerota, Poirier, Cuneo and Delamere, and Sappey tobe subsidiary, under normal conditions, to the cutaneous route. The mammary lymphvessels are divided by Poirier and his co-workers into the cutaneous and the glandular.The cutaneous lymph vessels differ in distribution in the central and peripheral portions
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Fig. ig.—Contents of the axilla shown by dissection made from before backward. of the organ. In the former two main trunks arise from a central sub-areolar plexus, runabove and below the areola and turn transversely outward to reach the thoracic group ofaxillary nodes. Some small trunks arise in the upper peripheral portions and pass overthe clavicle to reach the supra-clavicular nodes of the deep cervical chain. Somemammary trunks seem to cross from one side of the chest to the other, thus creating ananastomosis between the two sets of mammary lymph vessels. SURGICAL ANATOMY OF THE BREAST 39 Olsner and Roeffel have demonstrated the existence of a lymphatic trunk that arisesin the lower inner quadrant of one breast and goes directly to the lymph nodes of theopposite axilla. The central cutaneous lymphatics begin in a fine network, beneath the areola, andnipple, and unite into several trunklets. These latter break up to form the sub-areolarplexus of Sappey in which a majority of the

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